Renu Dhasmana1, Sonal Sah2, Neeti Gupta3. 1. Professor, Department of Ophthalmology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University , Dehradun, Uttarakhand, India . 2. Retina Fellow, Department of Ophthalmology, Eye Q, Prakash Netra Kendra , NH2, Vipul Khand IV, Gomti Nagar, Lucknow, Uttar Pradesh, India . 3. Assistant Professor, Department of Ophthalmology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University , Dehradun, Uttarakhand, India .
Abstract
INTRODUCTION: Diabetic retina undergoes degenerative changes in retinal nerve fiber layer (RNFL) in addition to vascular changes. Loss of RNFL with changes in inner retina and their association with metabolic control have been studied with varied results in diabetic patients. AIM: To compare the RNFL thickness between diabetic patients and age matched healthy controls and to correlate the thickness to metabolic control. MATERIALS AND METHODS: One hundred and sixty five patients were enrolled in the study out of which 50 served as controls, 58 patients were diabetic without retinopathy and 57 patients had diabetic retinopathy. Both eyes of all patients underwent optical coherence tomography scans for RNFL and ganglion cell complex. Foveal and parafoveal thickness were also measured. All the parameters were compared to patient's metabolic control. RESULTS: RNFL thinning was observed in superotemporal (p-value = 0.001) and upper nasal sectors (p-value = 0.031) around the optic disc in eyes with diabetic retinopathy. Ganglion cell complex also showed statistically significant thinning in diabetic patients. Creatinine levels showed a weak negative correlation to the RNFL. CONCLUSION: This study positively concluded that neurodegeneration in an early component of diabetic retinopathy.
INTRODUCTION:Diabetic retina undergoes degenerative changes in retinal nerve fiber layer (RNFL) in addition to vascular changes. Loss of RNFL with changes in inner retina and their association with metabolic control have been studied with varied results in diabeticpatients. AIM: To compare the RNFL thickness between diabeticpatients and age matched healthy controls and to correlate the thickness to metabolic control. MATERIALS AND METHODS: One hundred and sixty five patients were enrolled in the study out of which 50 served as controls, 58 patients were diabetic without retinopathy and 57 patients had diabetic retinopathy. Both eyes of all patients underwent optical coherence tomography scans for RNFL and ganglion cell complex. Foveal and parafoveal thickness were also measured. All the parameters were compared to patient's metabolic control. RESULTS: RNFL thinning was observed in superotemporal (p-value = 0.001) and upper nasal sectors (p-value = 0.031) around the optic disc in eyes with diabetic retinopathy. Ganglion cell complex also showed statistically significant thinning in diabeticpatients. Creatinine levels showed a weak negative correlation to the RNFL. CONCLUSION: This study positively concluded that neurodegeneration in an early component of diabetic retinopathy.
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